News from ACC 2017: Rivaroxaban vs. Aspirin to Prevent Recurrent VTE / Evolocumab's Clinical Outcomes / More... — Physician’s First Watch

Medical News |
March 20, 2017

News from ACC 2017: Rivaroxaban vs. Aspirin to Prevent Recurrent VTE / Evolocumab's Clinical Outcomes / More...

By the Editors

The American College of Cardiology's annual meeting brought forth a flood of heart-related medical news this weekend. Here's a quick look at the studies we thought you'd be most interested in:

Rivaroxaban vs. Aspirin for Recurrent VTE: Nearly 3400 adults with venous thromboembolism who'd completed 6–12 months of anticoagulation were randomized to daily rivaroxaban (20 or 10 mg) or aspirin (100 mg). At 1 year, rates of symptomatic recurrent VTE were significantly lower with rivaroxaban (1.5% and 1.2%) than with aspirin (4.4%), with no differences in major bleeding across the groups. Dr. Allan Brett of NEJM Journal Watch General Medicine tells us what the findings mean for clinicians at the link below.

Evolocumab and Clinical Outcomes in CVD: Roughly 28,000 statin-treated patients with atherosclerotic cardiovascular disease and LDL levels of 70 mg/dL or higher were randomized to receive the subcutaneous PCSK9-inhibitor evolocumab or matching placebo. LDL levels were reduced by 59% with evolocumab. Additionally, during some 2 years' follow-up, major cardiovascular events occurred significantly less often with evolocumab than with placebo (9.8% vs. 11.3%). NEJM Journal Watch Cardiology's Dr. Harlan Krumholz examines the significance of the findings and speculates on the drug's pricing.

Uninterrupted Dabigatran vs. Warfarin for Ablation in Afib: Some 635 patients undergoing atrial fibrillation ablation were randomized to uninterrupted dabigatran or uninterrupted warfarin. The primary endpoint — major bleeding around the time of the procedure and up to 8 weeks afterward — occurred significantly less often with dabigatran than with warfarin (1.6% vs. 6.9% of patients). Thromboembolic events did not differ between the groups. Dr. Mark Link of NEJM Journal Watch Cardiology says the findings will change his practice. Read more at the link below.

TAVR vs. Surgery in Severe Aortic Stenosis and Intermediate Surgery Risk: In an 87-site randomized trial, transcatheter aortic-valve replacement (TAVR) with a self-expanding prosthesis was compared with surgery in patients who had severe aortic stenosis and intermediate surgical risk. The primary endpoint, death or disabling stroke at 2 years, occurred in 12.6% of the TAVR group and 14.0% of the surgery group, a nonsignificant difference. See more of the study's outcomes, and Dr. Howard Herrmann's take on the study, at the link below.

Links to NEJM Journal Watch Cardiology's coverage of six other studies presented at ACC are also provided below. Enjoy!

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